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Visualising speech: Identification of atypical tongue-shape patterns in the speech of children with cleft lip and palate using ultrasound technology
(NHS Greater Glasgow & Clyde and University of Strathclyde, Glasgow, 2018) Lloyd, Susan; Cleland, Joanne; Crampin, Lisa; Campbell, Linsay; Zharkova, Natalia; Palo, Pertti
Previous research by Gibbon (2004) shows that at least 8 distinct error types can be identified in the speech of people with cleft lip and palate (CLP) using electropalatography (EPG), a technique which measures tongue-palate contact. However, EPG is expensive and logistically difficult. In contrast, ultrasound is cheaper and arguably better equipped to image the posterior articulations (such as pharyngeals) which are common in CLP. A key aim of this project is to determine whether the eight error types made visible with EPG in CLP speech described by Gibbon (2004) can be also be identified with ultrasound. This paper will present the first results from a larger study developing a qualitative and quantitative ultrasound speech assessment protocol. Data from the first 20 children aged 3 to 18 with CLP will be presented. Data are spoken materials from the CLEFTNET protocol. We will present a recording format compatible with CAPS-A to record initial observations from the live ultrasound (e.g. double articulations, pharyngeal stops). Two Speech and Language Therapists analysed the data independently to identify error types. Results suggest that all of the error types, for example fronted placement and double articulations can be identified using ultrasound, but this is challenging in real-time. Ongoing work involves quantitative analysis of error types using articulatory measures.
Visualising speech: Using ultrasound visual biofeedback to diagnose and treat speech disorders in children with cleft lip and palate
(NHS Greater Glasgow & Clyde and University of Strathclyde, Glasgow, 2017-09) Cleland, Joanne; Crampin, Lisa; Zharkova, Natalia; Wrench, Alan A.; Lloyd, Susan; Palo, Pertti
Children with cleft lip and palate (CLP) often continue to have problems producing clear speech long after the clefts have been surgically repaired, leading to educational and social disadvantage. Speech is of key importance in CLP from both a quality of life and surgical outcome perspective, yet assessment relies on subjective perceptual methods, with speech and language therapists (SLTs) listening to speech and transcribing errors. This is problematic because perception-based phonetic transcription is well known to be highly unreliable(Howard & Lohmander, 2011) especially in CLP, where the range of error types is arguably far greater than for other speech sound disorders. Moreover,CLP speech is known to be vulnerable to imperceptible error types, such as double articulations which can only be understood with instrumental techniques such as ultrasound tongue imaging (UTI). Incorrect transcription of these errors can result in misdiagnosis and subsequent inappropriate intervention which can lead to speech errors becoming deeply ingrained.
Labial-Lingual Double Articulations in Speakers With Cleft Palate.
(Allen Press, 2002-01) Gibbon, Fiona; Crampin, Lisa
Objective: Labial-lingual double articulations (LLDAs) are speech errors involving simultaneous valving at the lips and in the linguapalatal region. This study investigates the frequency of LLDAs occurring for /p/, /b/, and /m/ targets and describes the linguapalatal contact patterns involved in these abnormal articulations. Design: A retrospective study involving analysis of articulatory data from all speakers with cleft palate recorded at a research center over a 10-year period. Participants: Twenty-seven speakers aged 5 to 62 years (median 11 years) with compensatory speech errors associated with repaired cleft palate. Measures: The lingual component of LLDAs was identified using electropalatography (EPG). EPG data were recorded simultaneously with acoustic data. Fifteen bilabial targets (/p/, /b/, /m/) per participant were analyzed. LLDAs were identified in cases where complete linguapalatal constriction (as observed from EPG data) occurred throughout the closure phase of bilabial targets. The labial component of LLDAs was identified from clinical observations of the speakers made during productions of bilabial targets. Results: Three speakers (11%) frequently produced LLDAs for bilabial targets. The configuration of tongue-palate contacts involved in the lingual component of the LLDAs differed in each of the three speakers: one speaker had velar constriction, another had alveolar constriction, and the third had simultaneous alveolar-velar constriction. LLDAs did not similarly affect bilabial targets in the three speakers. One speaker produced LLDAs for /p/ and /b/ targets only. Another produced LLDAs for all /m/ targets but inconsistently for /p/ and /b/ targets. The third speaker produced LLDAs for all /b/ targets but inconsistently for /p/ and /m/ targets. Conclusion: LLDAs occurred in a minority of speakers investigated. Nevertheless, it is argued that it is important to identify LLDAs for clinical decision making and for research purposes. The results from this study add to current knowledge about abnormal articulations in cleft palate speech, but further research is needed into the precise timing of lip and tongue-palate closures and into the airflow and acoustic characteristics of LLDAs.

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